People who abstain from drinking alcohol are not at any greater risk for premature death than those who are light drinkers, according to a new UCSF analysis published in the February issue of the journal, Addiction.

The analysis, conducted by a team of researchers in the UCSF School of Nursing, provides new findings in the ongoing controversy regarding the health benefits of light drinking versus abstaining. Several recent much-publicized studies have suggested that abstainers are at greater risk of mortality than light drinkers.

The UCSF team, in collaboration with researchers in Sweden and several other countries, used the data from 10 mortality follow-up studies conducted elsewhere to carry out its analysis. The goal of the UCSF team was to re-analyze this information using consistent criteria.

The UCSF study found that there were important characteristics of drinking groups that were not always considered in previous studies.

"Our findings cast some doubt on the conclusions of other research that there are protective effects of light or moderate drinking," said Kaye Fillmore, PhD, professor in the department of social and behavioral sciences of the UCSF School of Nursing and principal investigator. "These effects have become accepted 'fact' without much attention paid to their many criticisms from the research community."

One of the concerns in many of the previous studies is that the measurement of drinking is not carefully delineated, according to Fillmore. The measurements used in the UCSF analysis were more carefully specified and therefore, may lead to more accurate results, she said.

The UCSF team defined light drinking as up to one drink per occasion for women and two drinks for men, or less than 15 occasions per month for both.

The researchers also found an important distinction between two types of abstainers--long-term abstainers and former drinkers--that are sometimes not taken into consideration in studies. Long-term abstainers are defined as those who never drank or who have not been drinkers for many years.

Analysis showed that several risk factors for premature mortality --other than drinking--were more prevalent among ex-drinkers than long-term abstainers. For example, adult men who are ex-drinkers are more likely to be heavier smokers, depressed, unemployed and to be of lower social class. Among women, ex-drinkers are more likely to be heavier smokers, in poorer health, not religious and unmarried than long-term abstainers.

These personal and lifestyle characteristics of the two groups of abstainers may "confound the relationships found between drinking and mortality risk," according to Fillmore.

"When these factors are statistically accounted for, abstainers of either type are not at higher risk for premature mortality than light drinkers," she said.

"What is important to remember is that all studies, these included, show that heavier drinkers are at considerable risk for earlier death. What we don't accurately know is the exact level of heavy drinking that predicts premature mortality."

The research was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and by a NIAAA Research Scientist Development Award to Fillmore.

By Dale Martin

1st appeared 2/2/98

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